PMID- 29878856
OWN - NLM
STAT- MEDLINE
DCOM- 20190607
LR  - 20190607
IS  - 1941-2703 (Electronic)
IS  - 1941-2711 (Linking)
VI  - 31
IP  - 5
DP  - 2018 Oct
TI  - Impact of Hypertonic Saline Solutions on Sputum Expectoration and Their Safety 
      Profile in Patients with Bronchiectasis: A Randomized Crossover Trial.
PG  - 281-289
LID - 10.1089/jamp.2017.1443 [doi]
AB  - BACKGROUND: The role of hyaluronic acid plus hypertonic saline (HA+HS) as a 
      mucoactive treatment in patients with bronchiectasis is still unknown. This study 
      evaluated whether HA+HS solution enhances similar sputum quantity with better 
      safety profile than HS alone in patients with bronchiectasis. METHODS: In this 
      double-blind randomized crossover trial, three solutions (7% HS; 0.1% HA +7%HS; 
      and 0.9% isotonic saline, IS) were compared in outpatients with bronchiectasis 
      and chronic sputum expectoration. Participants inhaled each solution across four 
      consecutive sessions. All sessions, except on session 3, also included 30 minutes 
      of airway clearance technique. A 7-day washout period was applied. Sputum weight 
      was collected during the sessions (primary outcome) as well as during a 24-hour 
      follow-up. The Leicester Cough Questionnaire (LCQ) and lung function were 
      measured before/after each treatment arm. Safety was assessed by the monitoring 
      of adverse events (AEs). RESULTS: Twenty-eight patients with bronchiectasis (mean 
      age of 64.0 (17.9) and FEV(1)% 60.9 (24.6) of predicted) were recruited. HS and 
      HA+HS promoted similar expectoration during sessions, both being greater than IS 
      [median difference HS vs. IS 3.7 g (95% CI 0.5-6.9); HA+HS vs. IS 3.2 g (95%CI 
      0.5-5.9)]. Sputum expectorated exclusively during the ACT period was similar 
      across all treatment arms [HS vs. IS -0.3 g (95% CI -1.7 to 0.9); HA+HS vs. IS 
      0.0 g (95% CI -1.3 to 1.4); HS vs. HA+HS 0.0 g (95% CI -1.2 to 0.4)]. Sputum 
      collected over the 24-hour follow-up tended to be lower for HS and HA+HS compared 
      with IS [HS vs. IS -1.7 g (95% CI -4.2 to 0.0); HA+HS vs. IS -1.1 g (95%CI -3.6 
      to 0.7)]. No differences in LCQ or lung function were observed. Most severe AEs 
      were reported using HS. CONCLUSION: HS and HA+HS were more effective on sputum 
      expectoration than IS in patients with bronchiectasis, reporting HA+HS better 
      safety profile than HS.
FAU - Herrero-Cortina, Beatriz
AU  - Herrero-Cortina B
AD  - 1 Universidad San Jorge , Zaragoza, Spain .
FAU - Alcaraz, Victoria
AU  - Alcaraz V
AD  - 2 Fundacio Clinic, Hospital Clinic de Barcelona, Universitat de Barcelona , 
      IDIBAPS, CIBERES, Barcelona, Espana.
FAU - Vilaro, Jordi
AU  - Vilaro J
AD  - 3 Facultat de Ciencies de la Salut Blanquerna, Universitat Ramon Llull , Grup de 
      Recerca en Salut, Activitat Fisica i Esport (SAFE), Barcelona, Spain .
FAU - Torres, Antoni
AU  - Torres A
AD  - 4 Servei de Pneumologia, Hospital Clinic de Barcelona, Universitat de Barcelona , 
      IDIBAPS, CIBERES, Barcelona, Espana.
FAU - Polverino, Eva
AU  - Polverino E
AD  - 4 Servei de Pneumologia, Hospital Clinic de Barcelona, Universitat de Barcelona , 
      IDIBAPS, CIBERES, Barcelona, Espana.
AD  - 5 Servei de Pneumologia, Hospital UniversitariValld'Hebron (HUVH), Institut de 
      Recerca Valld'Hebron (VHIR) , Barcelona, Espana.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20180607
PL  - United States
TA  - J Aerosol Med Pulm Drug Deliv
JT  - Journal of aerosol medicine and pulmonary drug delivery
JID - 101475057
RN  - 0 (Expectorants)
RN  - 0 (Saline Solution, Hypertonic)
RN  - 9004-61-9 (Hyaluronic Acid)
MH  - Aged
MH  - Aged, 80 and over
MH  - Bronchiectasis/physiopathology/*therapy
MH  - Cross-Over Studies
MH  - Double-Blind Method
MH  - Expectorants/adverse effects/*therapeutic use
MH  - Female
MH  - Forced Expiratory Volume
MH  - Humans
MH  - Hyaluronic Acid/adverse effects/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Saline Solution, Hypertonic/adverse effects/*therapeutic use
MH  - *Sputum
OTO - NOTNLM
OT  - airway clearance techniques
OT  - bronchiectasis
OT  - hypertonic solutions
OT  - mucoactive treatment
OT  - sputum expectoration
EDAT- 2018/06/08 06:00
MHDA- 2019/06/08 06:00
CRDT- 2018/06/08 06:00
PHST- 2018/06/08 06:00 [pubmed]
PHST- 2019/06/08 06:00 [medline]
PHST- 2018/06/08 06:00 [entrez]
AID - 10.1089/jamp.2017.1443 [doi]
PST - ppublish
SO  - J Aerosol Med Pulm Drug Deliv. 2018 Oct;31(5):281-289. doi: 
      10.1089/jamp.2017.1443. Epub 2018 Jun 7.